Posted 2 years ago on March 27, 2012, 3:24 p.m. EST by Jflynn1964
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CHIEF JUSTICE ROBERTS: Well, the same, it seems to me, would be true say for the market in emergency services: police, fire, ambulance, roadside assistance, whatever. You don't know when you're going to need it; you're not sure that you will. But the same is true for health care. You don't know if you're going to need a heart transplant or if you ever will. So there is a market there. To -- in some extent, we all participate in it. So can the government require you to buy a cell phone because that would facilitate responding when you need emergency services? You can just dial 911 no matter where you are?

GENERAL VERRILLI: No, Mr. Chief Justice. think that's different. It's -- We -- I don't think we think of that as a market. This is a market. This is market regulation. And in addition, you have a situation in this market not only where people enter involuntarily as to when they enter and won't be able to control what they need when they enter but when they --

CHIEF JUSTICE ROBERTS: It seems to me that's the same as in my hypothetical. You don't know when you're going to need police assistance. You can't predict the extent to emergency response that you'll need. But when you do, and the government provides it.

53 Comments

Both Obamacare and single payer are idiocy at its finest. Under current medical rates and fees, the average person born today can expect to expend at least a million dollars over his or her lifetime for healthcare; in a country of 310 million (and growing exponentially) that's 310 trillion which is entirely, completely, wholly, unaffordable now or at anytime within the near future, of revenue derived during that lifetime.

And what are we doing? We're proving free healthcare to illegals... we can't afford healthcare for our own and we're giving it away to an entire third world continent.

National health insurance? Sure, my employer will opt out of private insurance-as-compensation and I will be forced to buy national health insurance; I'll refuse and take the $2500 or $3500 hit of tax and theft and so will everybody else. It's juvenile to view this in any other light. And what do you suppose the government with all of its bureaucracy and corruption is going to do with that measly 3500?

I believe we charge about $225 for a 3 view shoulder x-ray exam. I assume you realize that you will need a doctor's order (referral for any imaging examination....ie: x-ray, CT, MRI etc).

My best advice would be to look in your local yellow pages, and make calls for estimated costs at facilities in your area. Prices will vary depending on which state you are in....in fact, the prices can vary quite a bit between facilities in the same area. I work in a free standing imaging center, and we charge about half what the hospital (located in the same town!) charges. Look in the yellow pages under "x-ray" or "physicians - radiologist" and start calling facilities.

He lost me with the cell phone thing. But everything else was good. It's not like we have a choice about police or fire services. I honestly don't see why there's a question. But then, maybe you need to be a constitutional expert to make the case why this is any different than SS and Medicare. Or police or fire services for that matter. Seems even the consitutional expert couldn't even make that case very well. Tee-hee-hee.

The difference between all of us, the nation as a whole, paying a tax to get a service and the gov't forcing us to buy a private sector product or service, is where the constitutional question comes in. I don't mind paying a fraction of my wages to ensure that we all get a much needed service, but I take offence at being forced to put my trust in a private sector company, especially since they are known to raise their rates every year. As a thirty five year old man who has been to the hospital maybe five times in my life, I am upset that I have to pay a for profit institution money to receive a service that I don't need. If I was forced to chip in to ensure those who are low on funds to receive a service they may use, ie, health insurance, well that is different and I would be proud to take on the extra liability, especially when I know some corporate twit is not getting a trip to Tahiti with my hard earned money. This is the difference I see when you compare a service provided through taxes and a mandated service through the private sector.

I hear ya. I'm not saying it's perfect. But what can we realistically expect when the government is a shit pit of corruption.

You're paying for it now, every time a non insured person ends up in the emergency room or hospital and cannot pay their bill. This just codifies it, and hopefully results in better preventative care and some measure of lower cost.

There are lots of services that the private sector provides to the government, that we all pay for. Which enriches the private sector. The biggest one that comes to mind is the military industrial complex.

Until we have single payer, or the 1% step up to provide medical charity to 30 million people in need, this is the best we're gonna get. And I think this, something, is better than nothing.

If SCOTUS rules that the mandate is constitutional, I won't be upset for pretty much the same reasons you listed; though, I will be surprised if the judges that ruled for citizens united found the mandate constitutional. If they do, i do believe they should forfeit their right wing credentials, lol.

Well, since Justice's Ginsburg and Kagan were pretty much presenting the defense for Verrilli, there is obviously no objectivity left on the side of the liberal justices; and after CU, the objectivity of the republican side was completely destroyed (what little may have been left). No, this will be another in the long line of 5-4 votes.

Because you don't have to buy car insurance. the insurance is something mandated when you choose to drive. Don't drive and then you won't have to buy car insurance. The luxury of driving comes with a cost, insurance. besides, car insurance mandates are state requirements.

The government and the legislators who crafted the Affordable Care Act should have changed the wording on the "purchase requirement" to levy a new tax instead of using wording that is "forcing" people to buy insurance. The bill should have created a new Medicare tax and simultaneously provided a tax break to anyone who already had health insurance. This would have created the same function, but without the notion that the government is "forcing" me and you to buy something.

That provision is the one flaw in an otherwise good bill. I hope that millions of elderly Americans aren't going to lose new healthcare benefits because of the gaffe that a few legislators made.

Yeah, don't worry about the whole Constitution thing. The Bill is so great, no doubt Congress would be happy to pass something new. LOL. This bill was so bad, even the liberal majority barely got it done.

When it doesn't involve income. The only thax the government has a right to impose a tax on is a "income". The constitution is very clear about that. Now they can impose a "direct tax" or an exise tax but thats a topic for another day.

I'm not talking about Obama. I'm talking about how the bill should have been written. It should have been written as a tax, not as a requirement for citizens to do something. Same thing, different semantics.

I thought the only argument against the bill was the required purchase part. What, exactly, do you not like about the rest of the bill? Is it solely because Democrats wrote it, or do you have a legitimate complaint against giving the elderly health care when they can't afford it, or helping people who would be disqualified for insurance due to already being sick getting the care they need?

Lots. It does nothing to fix the problems and shoves more costs on the states.

Better reform:

end 50 state regulation. It increases churn as even moving disrupts coverage. It also artificially concentrates markets making them easier for companies to control.

severely limit immigration of unskilled people. Unskilled people have great trouble paying for their own healthcare. The more we let in, the worse it gets.

stop making stripped down policies illegal. Politicians keep forcing more things into policies, like Sanda Fluke's issue. They should allow for less. People fundamentally think including things in policies makes things cheaper. The opposite is true, of course.

end "free" care. When people think things are free, they overconsume. That's inflationary. Obama made more things "free". Guy in New York on Medicaid called the ambulence 600 times. Why? Because he thought it was free.

Your second point shouldn't be in a healthcare bill, but in an immigration bill. It would make no sense to add something like that to a healthcare bill.

On the third point, I would much rather pay for the contraception than for the much costlier unwanted births. An unwanted child will cost taxpayers tons of $, especially if that child need medical attention or is orphaned, plus there are administrative and court costs for enforcing child support payments, schooling expenses, etc. Not to mention that reducing the number of unwanted births will correlate to a reduction in violent crime. I want kids to be born when the family plans for it, not at unwanted times. Unwanted births lead to poverty, and poverty leads to crime.

BTW "don't have sex" is not a valid argument. You can't stop human nature, no matter how much some imaginary being says so. It is better to give people the tools to prevent pregnancies than to scold them after-the-fact while shelling out thousands for that new kid.

On your fourth point, Canada and European countries seems to be doing well with their "free" care provisions. In fact, those healthcare systems are a very strong incentive for people to move out of this country.

BTW its not "Obama" that wrote this bill. Take your blame and put in on Congress. The POTUS does not have "writes bills" as part of his job duties. I'm tired of conservatives saying everything is Obama's fault when they are talking about something that Congress did. Put your blame in the right place.

But mass immigration is a driver of healthcare problems. The immigration bills are just vehicles for amnesty. The problem is simply that unskilled people have trouble buying things for obvious reasons. They especially have trouble buying their own healthcare. Immigration is a healthcare problem and belongs in a healthcare bill.

On contraception, it's for someone to handle themselves. The idea that someone can't buy birth control, but can buy a policy containing contraception is just silly. When costs are buried and on someone else, less efficient decisions are made. Burying rountinue costs in policies makes nothing cheaper, it just adds overhead.

Other countries ration. In particular, they use wait times and simply don't cover everything people want. Also, some countries treat end of life care very differently than we do. Roght or wrong, we try everything, Europe tends not to. That creates big spending differences. You should know that private insurance covers more than government do; this is even true already in the U.S. comparing Medicare and Medicaid to the private sector.

"But mass immigration is a driver of healthcare problems. The immigration bills are just vehicles for amnesty. The problem is simply that unskilled people have trouble buying things for obvious reasons. They especially have trouble buying their own healthcare. Immigration is a healthcare problem and belongs in a healthcare bill."

The only thing concerning immigration that should be on a healthcare is whether that care will be provided to undocumented persons.

What do you have against latinos who are trying to make a better life for themselves? You do realize that everyone on this land except for a very tiny minority are or were immigrants, right?

"On contraception, it's for someone to handle themselves. The idea that someone can't buy birth control, but can buy a policy containing contraception is just silly. When costs are buried and on someone else, less efficient decisions are made. Burying rountinue costs in policies makes nothing cheaper, it just adds overhead."

I think its silly that I will have higher premiums because of some other people having a bunch of babies. I'd rather have a few cents added to my premiums to prevent the unwanted births than pay a few dollars extra to cover the additional costs of those unwanted births.

The fact that birth control also has medical uses outside of family planning pushes me to support covering it as a medication. It seems hypocritical to me that we are a-OK with covering Viagra and other 'male performance enhancement' drugs through health insurance (which have no other medical use besides sexual improvement) yet we refuse to cover something that is proven to work for treating various women's health problems.

The whole contraception thing irks me, because it is clearly a ploy to inject more religious law into something that religion has no right to intrude in. Again, if you're going to rail against wasteful health insurance policies, ban Viagra first, not something that has actual medical value.

"Other countries ration. In particular, they use wait times and simply don't cover everything people want. Also, some countries treat end of life care very differently than we do. Roght or wrong, we try everything, Europe tends not to. That creates big spending differences. You should know that private insurance covers more than government do; this is even true already in the U.S. comparing Medicare and Medicaid to the private sector."

These are fair points. I would rather see a hybrid public-private system, where optional private plans cover whatever the government does not. Since I'm healthy I'd rather pay less for my health insurance, so I would rather take the government/public plan, and then have the option to go private when I'm in retirement.

"I know Bammy didn' t write the bill, but it's certainly his policy."

Its not "his" policy. Its the Democratic Party policy. A bunch of people sat together in a room and drafted these bills. The President, however, gets all of the flac for them because he is the PR person for the country. If you don't like the policies that much, vote against Democrats this November.

Oh Lord, where to start. What do I have against Latinos? It has nothing to do with ethicity, it has to do with not having skills and what not having skills means in terms of employment, income, and then the ability to pay for your healthcare. I just gotta ask, is there something special about Latinos where this doesn't apply? I mean there must be, right?

Similiarly, there's nothing about someone's motives that makes them suddenly able to buy their own healthcare. If someone comes here, cleans toilets for a living because they have no skills, but is trying for a better life, they suddenly are able to buy their healthcare? It's their motives, not their skills that drives the issue? Again, this I gotta hear explained.

The more routine things we plow into policies, the more inflation we spur. People really just don't have it through their heads that running rountine things through insurance companies increases costs because now it includes overhead. Our population is sadly just too stupid; if they don't see the costs directly, they think it's free.

It is his plan. He pushed it. He signed it. He touts it (well, at least he used to).

"It has nothing to do with ethicity, it has to do with not having skills and what not having skills means in terms of employment, income, and then the ability to pay for your healthcare."

And this is your argument for NOT being racist against Latinos? There are plenty of Latinos all of this country that are smarter and more skilled than you. I can also point you to plenty of white, black, asian, and other people in my neighborhood that can't even spell the word "skills." Typical conservative trash, hating on others because of where they came from. Go move to Iran. Hate is welcome over there!

Oh, and enjoy cleaning your own toilets, because without any of these low skilled laborers, who you assholes think are worthless to society, that toilet isn't going to clean itself. We need low-income laborers or else society doesn't work. Unless you are willing to grow your own food, build all of your own tools, build your car, mine and refine the oil that fuels that car, weave your own clothes, and build your own electronics with raw materials that you personally mined, you better be thankful for all of the thousands of people that made your comfy life possible.

"The more routine things we plow into policies, the more inflation we spur. People really just don't have it through their heads that running routine things through insurance companies increases costs because now it includes overhead. Our population is sadly just too stupid; if they don't see the costs directly, they think it's free."

Its not free. I told you that I would rather pay the few cents (because that's what it will be when the cost is spread out among millions of people) than the costs of those unwanted kids being born.

Do you know basic math? Lets do some basic math:

Lets say that we want to add coverage for the Plan B Morning-After pill. It costs $50 per pill. We know that 48% of our customers are female, and estimate that 20% of those customers will need this pill once per year. The total additional cost to each customer's premium, assuming that this company has 1,000,000 customers, is:

In the example above, premiums would increase by $4.80. That's less than the price of a fast food combo... Divide that amount by the number of payments per year (lets say monthly) and our hypothetical premiums went up by a BACK-BREAKING 40 cents. OMG OBAMACARE IS EVIL ITS MAKING ME SPEND 40 CENTS OH F***!!!!

There is no extra administrative cost. All insurance companies already have systems in place to handle prescription drug care, and this would be easily added to that system. You could argue for maybe some technical writing and data entry labor to modify a few coverage documents to reflect the new additions. I don't see you conservatives running around like chickens with their heads cut off if insurance companies go through this process for, say, Viagra. How much does it cost me to keep your boners working, huh?

"It is his plan. He pushed it. He signed it. He touts it (well, at least he used to)."

Rush Limbaugh touts a bunch of things as well. Should I place all of the blame on him if he touted the "stand your ground" laws that killed Treyvon Martin. After all, if he pushed it, obviously he is the ONLY person that could have been responsible for it. That's like blaming Hitler alone for all of the killings that the Nazis carried out. Last time I checked we put all of those bigots on trial, not just the highest-in-command.

I know its hard for you to understand in your black-and-white world that more than one person can work together to accomplish things. Go back to elementary school and learn what teamwork is, because the reality is that there isn't just one guy running this Democrat show, its millions upon millions of us, and there will be millions more from the newest generations that are waking up to conservative lies and bullshit.

You get more emotional as you go. Breathe and then think. Yeah, that's my agurment for not being racist against against Latinos. You brought up Latinos. I was simply curious why you'd think being Latino or trying to have a "better life" somehow suspended the consequences of adding no skill people that won't be paying their own healthcare bills to our society.

I didn't say anyone is worthless and being able to reason doesn't make me an asshole. But not being able to reason does make you stupid. I said that flooding the country with people that do menial jobs is bad for healthcare. The amount of menial work isn't some fixed amount that just has to get performed, it adjusts with price. As we flood the market, prices fall for those tasks and we do more of those tasks. It's flexible. As the price falls, people do all sorts of things more from nail salons, to yard work, to maid services, to eating in restaurants, to using valet parking. The list is endless.

If you want to make healthcare better in the U.S., lessen the flow of unskilled future, and obvious, "have nots" entering the country, whatever ethnicity.

The more we load into healthcare plans, the higher the costs. When someone else pays, we're all less careful about costs. It spurs inflation. We should be going the other way, making stripped down policies more legal, not less legal. I can rent a basic apartment or buy a car without a sunroof, but for some reason, they think they're doing people a favor making basic insurance illegal. And people buy it because they think they' getting something for free and the evil insurance company is paying. They're wrong.

"The more we load into healthcare plans, the higher the costs. When someone else pays, we're all less careful about costs. It spurs inflation. We should be going the other way, making stripped down policies more legal, not less legal. I can rent a basic apartment or buy a car without a sunroof, but for some reason, they think they're doing people a favor making basic insurance illegal. And people buy it because they think they' getting something for free and the evil insurance company is paying. They're wrong."

So are you going to dispute my math? Or are you just going to keep being vague? Why are you against paying $.40 in the example above to help improve women's lives?

That's the problem with you conservatives, all you see are the $$$ signs. You don't see the people that are affected by these policies. You see supply-and-demand. I see a mother who left her home and is trying to give their kids a better shot than they would have had in drug-riddled Mexico. I see women's lives being destroyed because a condom broke, all you see is a slightly higher healthcare bill.

I don't buy into the "this country is only for the 'haves'" mentality. We NEED people from every walk of life to keep this country working. Tell me, can you line up 5000 Caucasian men and women who are willing to drive to Maine for 3 months, endure backbreaking labor conditions to pick blueberries at $2 a bushel?